Colic is NO Myth….
(And it happens to around 1 in 5 babies)

When our son was first diagnosed with colic, I vividly remember reading statements like “there is no such thing as colic”. My gorgeous little baby was inconsolable: red faced with ear-piercing screams, his fists were clenched and his knees were drawn up to his chest. Clearly there was a problem. A problem the doctor had labelled ‘colic’, but there I was reading an article that said that colic was a “myth”. What the??!!! Confusing is an understatement.

It took me time and extensive research to understand that the confusion boiled down to an academic debate about the meaning of the word ‘colic’. Nobody was actually denying the well-documented phenomenon of excessively crying babies, what they were really arguing about was what caused that crying.

So What IS Colic Anyway?
The most commonly accepted medical definition of colic is called the ‘Rule of Threes’: a baby who is otherwise healthy and has had their needs met, but still cries for more than three hours a day, for more than three days in a week, for more than three weeks.

Colic is a surprisingly common problem. Estimates of the number of babies affected vary widely, but a middle figure of around 20% is commonly accepted. That’s around one in five babies regularly screaming for over three hours in a day…

If your baby is crying excessively, don’t just assume that the cause is colic, because there are other serious conditions that have similar symptoms. However if you’ve been to see your doctor and the your was colic, you are not alone. It is estimated that only around 5% of the babies that present to their doctor because of ‘excessive crying’ will have an underlying organic medical cause. That leaves the other 95% (assuming the extent of their crying is sufficient to meet the criteria for the Rule of Threes) in the residual category of ‘colic’.

Debate about the Cause of Colic
Amongst the experts there is fierce debate about what causes that colic. They generally fall into two broad camps: those who believe that colic has a gastrointestinal cause and those who believe it has an environmental cause.

A baby suffering from colic has their legs drawn up to their chest, a pain-like expression on their face and some will also fart explosively. In our case, the most amazing monster-farts would escape from our innocent little baby. Some experts believe that something in a colicky baby’s digestive system is not working the way it should be and that is causing the pain and the gas. There are a whole range of possible culprits: it may relate to the microflora (bacteria) in the digestive system, certain gut hormones, pain signals from sensitised nerves in the gut or lactose intolerance in babies, including a related theory that it is a transient deficiency in the enzyme that breaks down lactose.

Other experts are convinced that the cause of colic is founded in environmental factors, such as overstimulation. They believe that affected newborns are not getting enough sleep and/or are exposed to more than their little brains are ready to handle. They argue that affected babies have not yet reached a level of development where they can self soothe and keep their own mental stimulation to a level that they can cope with. As a result their little brain becomes overloaded and they begin to scream (and can’t stop). A related view is that affected babies are in need of better settling, using more advanced settling techniques that mimic the particular stimuli babies are used to from the womb environment in order to calm them down.

“Colic is a Myth” is Really Just a Debate About the Definition of Colic…

The confusion arises because most dictionary definitions of colic focus on a gastrointestinal cause. For example the Oxford dictionary defines it as: “severe pain in the abdomen caused by wind or obstruction in the intestines and suffered especially by babies.” By contrast, the most commonly accepted medical definition (see above) focuses on the duration of the crying, rather than its underlying cause.

So people that make statements like “colic is a myth” or “there is no such thing as colic” are using the word colic in its dictionary meaning, rather than the medical definition. Their intention is to deny that there is a gastrointestinal cause of colic, they are not meaning to deny the well-documented phenomenon of excessively crying babies. Experts who make these statements generally believe that there is a wide range of ‘normal’ crying in babies – that some just cry more than others – and the solution for an excessively crying baby is good settling techniques and/or reducing stimulation for the baby and making sure they get enough sleep.

As a parent of a baby that wouldn’t stop screaming, when I realised that this was just an issue of semantics, I have to say I was frustrated. It shouldn’t have been necessary for me to do that much reading, just to figure out that this was an academic disagreement!

At this point in time, nobody has been able to definitively prove the cause of colic or find a universal solution to it. There have been quite a number of promising research studies on different options that have helped a significant number of the babies involved in those studies, but as yet there is no universal answer. No universal answer, means neither camp has the medical evidence to back up claims that that they have the ‘right’ answer to what causes colic.

In light of that, making concrete statement like ‘colic does not exist’ seems unhelpful and misleading.

My View

Personally, I believe that part of the problem is that a distressed baby has only one main way to show that – by crying (a lot!). When you think about it, the ‘Rule of Threes’ medical definition of colic really just boils down to ‘a baby that cries a lot’. And the ‘Rule of Threes’ is usually the criteria on which babies are admitted to any particular study.

It seems plausible to me that both camps of experts may actually be right (to a degree), in that some babies may be crying because of a gastrointestinal issue and other babies because they are overstimulated (or in need of more sleep or better settling). If that’s right, then it starts to makes sense that one solution is unlikely to work for both those groups of babies, because they have different underlying problems. And different studies might have different proportions of babies with each problem, skewing the results and also make results hard to replicate consistently (which is what doctors and scientists want to see before research is considered reliable).

In the absence of conclusive scientific evidence, I believe that the traditional black and white approach where one camp says the other is “wrong” is unnecessary and just adds to the confusion and stress for parents. Especially when parents try their hardest with one particular approach that is supposed to be the only answer and that approach doesn’t work.

Instead let’s open up to the possibility that maybe both camps are “right” (in relation to some babies anyway). Let’s start explaining to parents that there is more than one possible cause for colic in their baby and give them information about all their options, including the pros and the cons of each, so that they can make their own informed decisions about what to try to help their baby.

Giving parents one-sided information, or telling them that ‘there’s no such thing as colic’, just isn’t fair when there are a range of options out there and the research indicates that not all babies will respond to the same solution.

Jen Lester is the author of Survivor’s Guide to Colic, available now in print or ebook from major retailers. www.survivorsguidetocolic.com

If you have any concerns about your baby’s health or the frequency or duration of your baby’s crying, please consult your doctor (please do not just assume your baby has colic because there are other serious medical conditions that can have similar symptoms).